Backdown on cuts to mental health counselling

A strict cap on treatment sessions for people with mental illness will be temporarily lifted. Flickr/spezoid.
Drastic cuts to mental health counselling services will be postponed for 9 months, after a decision by the Federal Government today to delay a major overhaul of the Better Access program.

Last November the Government announced a $580m cut to the program which included a cap on the number of yearly counselling sessions mental health patients could claim from Medicare at 10 - down from 18.

Psychologists said the change, designed to save about $100m, would leave about 87,000 patients cut off from help. Some doctors’ groups criticised the overhaul of Better Access as an attack on patient access to mental health care.

But in a move that suggests the government has softened its stance, it announced that GP patients will get access to up to 10 counselling sessions and will also be eligible for a further six in “exceptional circumstances”, to be decided by the GP.

The turnaround will be temporary, however. It will take effect in March and end on December 31.

A statement from the office of the Minister for Health and Ageing, Mark Butler said: “While Better Access was neither designed nor intended to provide intensive services or ongoing therapy for people with severe and persistent mental illness, the Government acknowledges there are some people with more complex needs who have come to rely on the program for support.

"We recognise that reducing the number of rebatable sessions has caused some community concern … . We will therefore reinstate the additional six services under ‘exceptional circumstances’ for a transitional period to 31 December 2012.”

Additionally, patients will continue to be eligible for Medicare rebates for 10 group therapy services per calendar year on top of their individual sessions.

John Mendoza, adjunct associate professor of medicine at the University of Sydney, said that Better Access had been designed to treat “people with what you might call common garden type mental health problems, such as mild depression, mild substance abuse and mild anxiety. It wasn’t meant for people with complex needs, but they ended up being the ones getting more than 10 sessions.”

Those patients would be better off receiving treatment under advanced counselling programs, many of which will be rolled out by the Federal Government over the next four years at a cost of about $500m, said Doctor Mendoza, who was also previously chairman of former Health Minister Nicola Roxon’s advisory council on mental health.

The Government’s announcement signalled that it had belatedly realised it didn’t have the proper care packages ready. “But now they’ve backed down on this, they’ll probably back down on more things, which is regrettable.”

The executive director of the Brain and Mind Research Institute at the University of Sydney, Ian Hickie, said the decision was borne out of political expediency.

“The Government realised it had to make this concession to keep the Greens onside, otherwise it wouldn’t get any of its other changes to mental health through the senate.

"We simply don’t know who was and wasn’t getting the proper care through Better Access. All we can hope is that the money being directed back to the program isn’t taken away from other more advanced packages to be introduced in coming years.”